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Different manifestation of a common primary HIV infection symptom?
Apr 17, 2001

Dear Dr,

Thank you from the bottom of my heart that you have been stretching your helping hands to those who desperately need some answers. I posted a question about couple weeks ago but went unanswered. I would appreciate it if you could kindly read my problem and answer my questions below. I hope this particular forum is the right place to post my question.

I had a protected vaginal intercourse with my girlfriend whom I have truly loved and respected. The condom broke and I washed away the vaginal secretions with cold water shortly after the incident, but I assume there were still some secretions unwashed. We both were tested negative by OraSure ELISA earlier. But, as much as I wanted to believe in my partner, her avoidance of getting tested again gave me impression that she was afraid of something, which ultimately made me think the HIV infection. The incidence took place in mid October. First 6 weeks, I did not have any symptoms other than joint paints in my hands and ankles and once in a while very strange and strong nausea feeling. This lasted first 3 weeks and next 3 weeks was symptom free. Starting at 6 weeks, my ears started becoming very sensitive to the noise. At 8 weeks and onward for the next two months, I felt like my both ears were quite stretched as if somebody was pulling them inwards. A durable pain sometimes accompanied this stretching feeling. Together with this, both sides of the underneath of my jaw, and facial muscles extending from head to the base of my neck painfully tingled. I also had nausea all along and short period of fatigue. I typically felt better when I laid down and got some rest. After 4 months, numbness on my skull and dizziness were added to the list of symptoms and tingling sensation and pain were mostly gone. In addition to these symptoms, I also had a lesion at 3 months at the base of my lower right tooth in my mouth that lasted for three weeks to heal, and an anal ulcer at 4.5 months, which bled for nearly two weeks during stool passages and healed afterwards. I did not have visibly enlarged lymph nodes but by looking at the locations of all these tingling and pain (http://calloso.med.mun.ca/~tscott/head/hnl3a.htm) , I assume that lymph nodes and possibly other glands on my face, underneath my jaw and along my neck were all sensitive and hurting. The lymph nodes under my arms also hurt. One node under my left arm got in fact swollen for two days. The hurting feeling in my armpits happened after the symptoms on my face.

To date, I still feel numbness on my skull, dizziness, stretching of my ears, and slight pain in my ears once in a while. Particularly, I find my skull numb when I wake up. This progresses down along my side facial muscles down to my neck in the morning and dizziness starts. Several times but every day, my armpits hurt for about 30 seconds. Especially dizziness and numbness on my head is quite scary which make me think that I might be progressing into HIV illness manifested by meningitis-like symptoms without my body producing any antibodies.

I got tested at 4, and 11 weeks with OraSure ELISA. I also got tested by blood ELISA at 13 and 19 weeks and RNA Viral load at 19 weeks (<50). The results were all negative. I will take another blood ELISA test sometime soon to complete the six months period. My questions are : 1) The ear problem that I experienced might be regarded as labyrinthitis, and HIV infection is given as one of the causes of this problem that might follow into meningitis (http://www2.utmb.edu/otoref/Grnds/Labyrinth-0005/Labyrinth-0005.htm). Is this ear symptom along with tingling and pain, dizziness and nausea a part of the symptoms of primary HIV infection? 2) Based on your vast experience, have you seen or are aware of anybody with the ear and facial symptoms like the ones I am describing as part of HIV infection? 3) Do the lymph nodes have to be swollen, and can they just be tender and sensitive accompanied with tingling sensation as part of primary HIV infection? 4) Based on your experience of all my symptoms and the tests that I took, do I have to worry about HIV and continue on getting tested, and for how long? 5) All my symptoms were on for several hours followed by several hours of break period. Is this a normal infection process? 6) What is your personal opinion about my symptoms?

I apologize for my long letter. But, I wanted to explain my symptoms with as much detail as possible for you to decide whether they are part of the list of known primary HIV infection symptoms. I appreciate the time that you take to read this and answer my questions. Sincerely.

A worried soul!

Response from Dr. Frascino

Dear Worried Soul,

As I hope you and our other readers know this Forum is dedicated to questions pertaining to HIV-related Fatigue and Anemia, questions pertaining to possible infection should be directed to our forum on Safe Sex, Prevention, and Transmission. Because you are indeed a "worried soul" and if you have to re-type such a lengthy question again, I'm sure you will become "fatigued," sol I'll try to put your mind at rest. Insertive vaginal sex (male risk in heterosexual coitus) is estimated to cause HIV infection 0.03% to 0.09% of the time. You and your partner rested negative sometime before your possible exposure. You have had 2 ELISAs and an RNA viral load, all of which are negative. Your symptoms are not indicative of meningitis or primary HIV infection. Based on your history, physical symptoms, and particularly your laboratory tests, you are not infected. Hopefully, you can now stop worrying - and typing.

Good luck.

RJF


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